Combined Effects of Motor Imagery and Core Stability Exercises in Stroke Patients

November 18, 2024 updated by: Riphah International University

Combined Effects of Motor Imagery and Core Stability Exercises on Trunk Control, Balance and Quality of Sleep in Stroke Patients

This research explores the combined effects of motor imagery and core stability exercises on trunk control, balance, and sleep quality in stroke recovery, addressing Pakistan's unique healthcare challenges. By enhancing neuroplasticity, core strength, and physical function, these interventions aim to improve mobility, independence, and overall quality of life for stroke survivors, while addressing common sleep disturbances.

Study Overview

Status

Enrolling by invitation

Conditions

Intervention / Treatment

Detailed Description

Stroke patients can benefit from motor imagery and mirror therapy, which are easy to perform anytime and anywhere at their convenience. Integrating motor imagery training with task-specific training leads to greater improvements in sit-to-stand performance compared to task-specific training alone. Core exercises, whether performed alone or combined with other therapies, have been shown to influence trunk performance in stroke patients compared to traditional training. Patients who have had strokes can benefit from rehabilitation training that focuses on strengthening their core muscles. This is likely because it thickens the transverse abdominis muscle. Post-stroke patients were able to regain their motor function and sense of independence with the use of motor imagery as an additional resource. It has been shown to be an effective therapeutic strategy for this particular patient population. More than with routine physiotherapy, core stability exercises on both stable and unstable support surfaces improve ambulatory stroke patients' trunk control, core muscular strength, standing weight-bearing symmetry, and balance confidence. Combined action observation and motor imagery therapy may be helpful for neurorehabilitation in chronic stroke survivors when physical practice is not appropriate. Compared to standard physical treatment alone, core stability exercise and conventional physical therapy has demonstrated better outcomes in trunk control and balance.

The combination of motor imagery and core stability exercises remains underexplored in stroke rehabilitation, leaving a significant knowledge gap about their synergistic potential. Investigating their combined effects could offer innovative strategies to improve trunk control, balance, and sleep quality, paving the way for more comprehensive and effective post-stroke treatment programs.

Study Type

Interventional

Enrollment (Estimated)

62

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab
      • Lahore, Punjab, Pakistan, 54000
        • Well Versed Physio clinic

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria: Adults aged 40-65 years.

  • Diagnosed with stroke (ischemic or hemorrhagic) within the last 6 months to 2 years.
  • Hemiplegic Patient
  • Having MMSE score ≥ 24
  • Experiencing balance impairments on BBS 21-40
  • Having sleep disturbances on PSQI 15-21.
  • Willing to provide informed consent.

Exclusion Criteria: Severe cognitive impairments (e.g., severe dementia).

  • Other neurological or musculoskeletal conditions affecting balance.
  • Severe cardiovascular or respiratory conditions contraindicating exercise.
  • Participation in another clinical trial within the past 3 months.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Core Stability Exercises and Motor Imagery
Core stability exercises are voluntary movements designed to maintain the balance, functional mobility, gait, fear of falling, and anticipatory postural adjustment among stroke survivors. Motor perception or motor imagery (MI) is a mental task that involves visualizing a physical movement without actually doing the action
Procedure: Core stability Exercises

The exercises have been divided into three difficulty categories based on the level of difficulty.

Level I: When the patients were unable to sit independently, level I core stability therapy was administered. First-level exercises were done in a supine position on a plinth. The workout program mostly included side bridging movements, leg crosses, one-leg curl-ups, and straight and diagonal reaching activities. Patients can move to level once they can sit on a plinth edge unsupported for one minute while flexing their knees and hips to 90 degrees.

Level II: Exercises included straight-arm curl-ups, diagonal-arm curl-ups, and arm curl-ups with the arms crossed. The patient will go to stage three once they can sit on an unstable surface for thirty seconds.

Level III: Using a physio ball, the exercises were done while seated. The exercises performed with the ball consisted push-ups, bird dog, side Bridge, abdominal curl-ups, and bridge movements

Procedure: Motor Imagery

The motor imagery program will be performed in three steps. STEP 1 Subjects will be instructed to watch the video provided and recorded by investigator. Two types of videos will be available to watch. One recording normal movements and the other film will contain recording the patient movements. Patient will be asked to watch the video and analyze the differences.

STEP 2 In next step participants will be asked to close the eyes to focus and then to imagine how they are doing task they had previously observed 10 times.

STEP 3 Participants will be than instructed to carry out the task in verbal commands given whenever necessary. During the recall process components of movement deviating from normal will be emphasized. The difficulty level of activities and the analysis of movement components will be increased gradually according to the patient's capacity.
Active Comparator: Core Stability Exercises
Core stability exercises are voluntary movements designed to maintain the balance, functional mobility, gait, fear of falling, and anticipatory postural adjustment among stroke survivors.
Procedure: Motor Imagery

The motor imagery program will be performed in three steps. STEP 1 Subjects will be instructed to watch the video provided and recorded by investigator. Two types of videos will be available to watch. One recording normal movements and the other film will contain recording the patient movements. Patient will be asked to watch the video and analyze the differences.

STEP 2 In next step participants will be asked to close the eyes to focus and then to imagine how they are doing task they had previously observed 10 times.

STEP 3 Participants will be than instructed to carry out the task in verbal commands given whenever necessary. During the recall process components of movement deviating from normal will be emphasized. The difficulty level of activities and the analysis of movement components will be increased gradually according to the patient's capacity.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
• Berg Balance Scale ( BBS)
Time Frame: 12th week
The Berg Balance Scale evaluates changes in static balance over time .Each item is a 5-point ordinal scale ranging from 0 to 4, with 0 indicating lowest level of function and 4 indicating highest level of function. It has 14 items and the maximum score is 56, higher the score, the better the balance function, while the lower the score, the worse the balance function.
12th week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Aruba Saeed, PhD, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 1, 2024

Primary Completion (Estimated)

February 28, 2025

Study Completion (Estimated)

May 30, 2025

Study Registration Dates

First Submitted

November 18, 2024

First Submitted That Met QC Criteria

November 18, 2024

First Posted (Estimated)

November 20, 2024

Study Record Updates

Last Update Posted (Estimated)

November 20, 2024

Last Update Submitted That Met QC Criteria

November 18, 2024

Last Verified

November 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR & AHS/24/0239

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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